African American grandparents' and adolescent grandchildren's sexuality communication

The Family System of Sexuality Communication: Extended Family Perceptions of Adolescent-Family Talk about Sex, with Sibling and Non-Sibling Comparison

Talk with parents and extended family about sex and relationships can support adolescents’ sexual health. However, few studies explore how parent and extended family communication with adolescents intersect. This study used thematic analysis to assess family roles in talk with teens about sex and relationships among a sample of 39 adult extended family members (such as aunts and uncles, and older siblings and cousins) in the United States. Analyses identified four themes in sexuality communication that address: why adolescents talk to extended family about sex and relationships, family engagement in these conversations, consistency of family messages, and family communication about adolescents. Findings identify variation in how family members interact with adolescents and one another regarding talk about sex and relationships. For example, some participants described family coordination of sexual messages to the teen, while others reported no family communication about this topic. Results also showed similarities and differences in how sibling and non-sibling extended family describe these processes. These findings identify the need to examine family talk about sex and relationships in the context of a larger family system, rather than only within dyadic relationships, and suggests possibilities for family-based interventions to support adolescents’ sexual health.

"Knowledge I seek because culture doesn't work anymore … It doesn't work, death comes": the experiences of third-generation female caregivers (gogos) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care

Background

Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. In many South African households, third-generation female caregivers, often grandmothers or other older females, locally known as gogos, are primary caregivers of children due to parents being deceased or absent. Subsequently, the responsibility of talking about sex and related issues has shifted to these gogos. This study explored the experiences of gogos living in Alexandra, Johannesburg on talking about sex, sexuality and HIV and AIDS with children aged 10–18 years that are in their care.

Methods

Ten primary caregivers were purposively selected. Data were collected through in-depth individual interviews. Thematic analysis was performed and inductive codes and themes identified.

Results

All gogos selected found it difficult to discuss sex, sexuality and HIV and AIDS due to culture and traditional values impacting on personal experiences as well as generation and gender barriers. Perceived low self-efficacy due to low levels of knowledge and limited skills in speaking about sex, sexuality and HIV and AIDS also contributed to low levels of sexual reproductive health communication.

Conclusions

This study highlights the need for interventions that focus on improving gogos’ knowledge about sexual reproductive health in addition to providing them with the skills to talk about sex, sexuality and HIV and AIDS with children in their care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10494-5.

A Comparison of the Process and Content of Sexual Communications Among African American Adolescent Children Living in Parent and Grandparent Headed Families

Introduction

The process of parental sexual communication has been shown to delay the sexual debut of adolescents; however, few studies have focused on extended family members such as grandparents. The purpose of this study was to compare the process and content of sexual communications among African-American adolescent children living in parent or grandparent headed families.

Methods

A secondary analysis of two de-identified datasets from 80 African-American adolescents was conducted.

Results

Findings indicated that there were no significant differences in the sexual communication process in relation to facilitators p= 0.38 and barriers p =0.23 with the discussions. There were however significant differences with adolescents’ attitudes (p = 0.04) and feelings regarding sexual abstinence (p =0.01), HIV prevention (p= 0.002) and teen pregnancy (p= 0.010).

Discussion

Researchers can use the results of this study as a beginning point in examining the sexual communication process in grandparent-headed families.

A Larger Ecology of Family Sexuality Communication: Extended Family Perspectives on Relationships, Sexual Orientation, and Positive Aspects of Sex

Extended family can be a resource for conversations about sex, but extended family perspectives have been largely left out of existing research. The present study investigates how extended family, such as aunts and uncles, siblings and cousins, perceive communication with teens in their families about sex. A thematic analysis was conducted with data from interviews in the U.S. with 39 extended family members, primarily siblings, who reported talk with teens in their families about sex. The analyses identified one theme focused on perspectives surrounding what is most important for teens to know about sex and relationships and seven themes focused on the content of conversations with teens about sex. The most prevalent content areas were: Healthy and Unhealthy Relationships (87%), Sexual Orientation (82%), Sexual Behavior (82%), and Protection (74%). The findings highlight extended family members’ unique roles in supporting the sexual health of teens in their families, which include providing information and support about issues other family members may not address, such as sexual orientation and the positive aspects of sex. The findings suggest the need to include extended family in sex education interventions to reflect the broader ecology of teens’ family relationships and access an underutilized resource for teens’ sexual health.

Youth Perspectives on Sexuality Communication With Parents and Extended Family

OBJECTIVE

To explore extended-family sexuality communication and compare it with parent sexuality communication.

BACKGROUND

Family communication about sex can protect teens from sexual risk behavior. However, most studies on this topic focus exclusively on the parent-teen dyad; few capture the broader context of teens' family communication.

METHOD

Using a mixed-methods approach, a convenience sample of 22 teens from diverse racial and ethnic backgrounds were interviewed. Participants were asked to identify family members with whom they talk about sex and relationships, topics discussed, messages shared, and the teens' comfort talking about sex and relationships. Thematic analysis was used to explore participants' shared meanings and experiences.

RESULTS

Eighty-six percent of teens reported talking with both parents and extended family about sex. Teens were more likely to report that parents than extended family shared messages about delaying sex and avoiding teen pregnancy and gave advice or shared information about sex. Teens were more likely to view extended family than parents as easy to talk with and as having shared life experiences, and some reported avoiding talk with parents about issues related to sexuality due to feeling awkward or fearing a negative reaction.

CONCLUSION

Extended family may play a somewhat different role than parents in teens' sexuality communication, but family members showed a largely common set of family values.

IMPLICATIONS

Extended family may be a valuable teen resource for sexuality communication, particularly when teens feel uncomfortable talking with parents.

Giving Our Daughters What We Never Received: African American Mothers Discussing Sexual Health With Their Preadolescent Daughters

African American girls experience disparate rates of pregnancy and acquisition of sexually transmitted infections, including human immunodeficiency virus, when compared to their non-Hispanic White counterparts. Among African American girls, current pregnancy rates are equal to the national crisis levels of teen pregnancy reported in 1990. This qualitative elicitation study was conducted to gain insight into the ways in which African American mothers and their daughters, between the ages of 9 and 14, communicate about sexual health. Early sexual health communication between mothers and daughters is known to enhance the sexual health outcomes of girls. A series of four focus groups and three in-depth interviews were conducted between July and September 2014. The theory of planned behavior was the organizing framework. Theoretical constructs that guided this study were attitudes, perceived behavioral control, and subjective norms. Results showed that what African American women share with their daughters about sexual health stems from their personal faith, values, and experiences. Findings from this study can inform interventions to provide support for this understudied population. Moreover, there are implications for health-care providers, particularly school nurses, who are in an ideal position to help increase mothers' self-efficacy to engage in sexual health conversations with their young daughters.

21st Century Parent-Child Sex Communication in the United States: A Process Review

Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

Facilitators and Barriers to Implementing Church-Based Adolescent Sexual Health Programs in Baltimore City

PURPOSE

Black churches are an important community resource and a potentially powerful actor in adolescent health promotion. However, limited research exists describing the factors that may influence the successful implementation of evidence-based adolescent sexual health programs in churches. In the present study, a multi-informant approach was used to identify facilitators and barriers to implementing adolescent sexual health programs in black churches.

METHODS

Nine Black churches located in Baltimore, MD, were recruited to participate in this study. The senior pastor and youth minster from each congregation participated in an in-depth interview (N = 18). A total of 45 youth (ages 13-19 years) and 38 parents participated in 15 focus groups. Qualitative data were transcribed verbatim and analyzed using a qualitative content analytic approach.

RESULTS

Participants agreed that comprehensive adolescent sexual health education should be available for youth in black churches. They also believed that abstaining from sex should be discussed in all adolescent sexual health programs. Three facilitators were discussed: widespread endorsement of church-based adolescent sexual health education, positive influence of youth ministers on youth, and life lessons as teaching tools. Four barriers are described: perceived resistance from congregants, discomfort among youth, lack of financial resources, and competing messages at home about sexual health.

CONCLUSIONS

Our findings suggest that churches are a preferred place for adolescent sexual health education among some parents and youth. Study findings also reinforce the feasibility and desirably of church-based adolescent sexual health programs.

Generational differences in the sexual communication process of African American grandparent and parent caregivers of adolescents

PURPOSE

This study assessed generational differences in the sexual communication process between 40 African American parent and 40 grandparent caregivers of adolescent children.

DESIGN AND METHODS

The study reports findings from a secondary analysis of data from two databases. The HIV Risk Reduction Survey was used to examine the sexual communication process.

RESULTS

Grandparents wanted to talk about sex and had open sexual communications, while parents valued sexual abstinence and had limited communications.

PRACTICE IMPLICATIONS

Based on the findings, healthcare providers and programs need to recognize that differences do exist between parents and grandparents with sexual communications.

African American Gay Family Networks: An Entry Point for HIV Prevention

Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.

African American grandfamilies' attitudes and feelings about sexual communication: focus group results

Little attention has been given to the responsibilities that African American grandparent caregivers face when they assume the role of raising their grandchildren. One particularly challenging task of grandparent caregivers is communicating with their grandchildren about sexuality issues. This study therefore examined the sexual communications and attitudes and feelings toward these communications between African American grandparent caregivers and their adolescent grandchildren (11-13 years of age). Focus group methodology was used to generate data about the grandparent/grandchild sexuality communication process and attitudes and feelings toward that process. The sample included 40 dyads of African American grandparents/grandchildren, for a total of 80 participants. Grandparents as well as their adolescent grandchildren desired open communication about sexuality issues, said that societal pressure makes sexual encounters hard to resist, and felt that they needed assistance with the sexuality communication process. Nurses can build upon the study's results to assist African American grandparents and their adolescent grandchildren with sexual communication.